Somayeh Delavari - Academia.edu (original) (raw)

Papers by Somayeh Delavari

Sleep and Breathing, 2011

There is a high worldwide prevalence of sleep quality disturbances, and sleep disturbances have b... more There is a high worldwide prevalence of sleep quality disturbances, and sleep disturbances have been associated with numerous diseases. Thus, it is important to assess sleep quality. The Pittsburgh Sleep Quality Index (PSQI) is a self-rating questionnaire that can be completed within 5 min, but no Persian language version is available. We translated the PSQI into Persian and then back into English to ensure the accuracy of the translation. A total of 125 psychiatric patients (generalized anxiety disorder, n = 37; major depression, n = 35; schizophrenia, n = 28; primary insomnia, n = 25) and 133 controls completed our Persian version of this questionnaire. Internal consistency, construct validity, and sensitivity and specificity of the PSQI were assessed. The mean ages (±SD) of the patient and control groups were 36.8 years (±13.9) and 34.2 years (±9.8), respectively (p = 0.08). Cronbach's alpha coefficient for all subjects was 0.77 and was 0.52 for the patient group and 0.78 for the control group. The corrected item-total correlations ranged from 0.30 to 0.75 for the seven component scores of the PSQI. When the general health questionnaire-12 was used as a measure of psychiatric morbidity, it was well correlated with the PSQI scores (r = 0.54, p < 0.001). The sensitivity and specificity of discrimination of insomniac patients from control subjects were 94% and 72% for a PSQI cutoff value of 5 and 85% and 84% for a PSQI cutoff value of 6. The psychometric properties of the Persian version of the PSQI were acceptable.

Caspian journal of health research, Jun 1, 2018

Background: Organizational efficiency should be continuously measured to plan for improvement, in... more Background: Organizational efficiency should be continuously measured to plan for improvement, informing about organizational performance, and guiding the university toward its goals. In this study, the authors measured the efficiency of schools affiliated to Tehran University of Medical Sciences as one of the most important universities in Iran, in 2011 and 2012. Methods: In this research, the efficiency of schools was measured using data envelopment analysis (DEA) technique in three dimensions of education, research, and development. Several indices in each dimension were assumed as input. Data were collected from university documents and analyzed by output oriented approach using DEAP software version 2.1. Results: Findings revealed that the efficiency scores of four schools including public health, pharmacy, nursing and midwifery, and advanced technologies were 100 in both years. In 2011, the efficiency scores for other schools were as follows:

DOAJ (DOAJ: Directory of Open Access Journals), Nov 1, 2020

Letter to Editor Dear Editor Emerging infectious diseases have always been one of the most seriou... more Letter to Editor Dear Editor Emerging infectious diseases have always been one of the most serious global public health threats. They have the potential to cause human infections, high economic burden, increased morbidity, and undermine the existing public health infrastructure. The ongoing battle against the epidemic of emerging infectious diseases requires frontline health professionals to work harder and become more diligent. Confronted with these demanding working conditions, medical and paramedical learners in teaching hospitals face numerous challenges, as they are at the forefront of providing primary medical services to patients suffering from COVID-19. For instance, they have to deal not only with the prejudice and social stigma of working with COVID-19 patients but also with the subsequent potential risk of contamination. 1 The tremendous emotional stress and potential suffering from anxiety form another challenge as learners witness the death of both colleagues and patients due to COVID-19 infection. Exacerbating the situation are the long hospital shifts, which potentially undermine the health safety and quality of life of learners. 2 Equally challenging are the long working hours, beyond mere professional dedication, which can lead to fatigue and burnout and adversely affect various aspects of their quality of life (health, physical, psychological, environmental, and social). 3 In turn, these exhausting conditions can lead to the relaxation of many of the usual safety standards, reduced quality of care, unethical behavior, and a higher risk of medical errors. 2 Empathy is an important factor in overcoming these challenges. It is defined as "The ability to understand and share another person's perspective and feelings, and using this understanding to guide future action". 4 Larson and others suggested that empathy can reduce aggressive behavior and improve helping behavior. 5 Empathy plays a fundamental role in the relationship between physicians and patients with COVID-19, as it involves cognitive, affective, and behavioral aspects. A prerequisite for successful management of patients with COVID-19 is to demonstrate empathy by all parties involved, from medical staff to medical and paramedical learners, patients, and their family caregivers. This has an immediate and longitudinal impact on patient-physician outcomes. Evidently, empathy has resulted in increased voluntary engagement by medical and paramedical students, both at undergraduate and postgraduate levels in managing COVID-19 patients. For example, both specialist physiotherapists and PhD candidates in physiotherapy have volunteered at various teaching hospital wards (dedicated to COVID-19 patients) to perform standard chest physiotherapy to improve patients' pulmonary function and reduce respiratory insufficiency. Medical interns have also voluntarily attended teaching hospitals to provide medical service to patients with COVID-19. Close collaboration between medical/paramedical learners and staff and between different hospital wards is essential in the fight against pandemic diseases such as COVID-19. Empathy cannot be achieved through explicit teaching alone. 5 Its development is a long process of learning medical ethics, role modeling, long-term observation of empathetic behavior demonstrated by health care professionals, and training on physician-patient communication skills. While empathy contributes to job satisfaction, the process of mastering empathetic behavior itself may result in psychological distress, emotional exhaustion, and burnout. 5 Therefore, medical education policymakers and heads of educational hospitals and clinical departments must address the specific physical and psychological needs of medical and paramedical learners. It is therefore recommended that nations invest more in wellness and health promotion. We trust that the global full-scale battle against COVID-19 will ultimately contribute to the enhancement of peace, collaboration, and friendship among nations. Together we will be able to defeat the COVID-19 pandemic.

Current Drug Safety, Feb 3, 2020

Background: Self-medication could be risky behavior and has negative effects. While Over the Coun... more Background: Self-medication could be risky behavior and has negative effects. While Over the Counter (OTC) drugs are available at drugstores, the behavior has become prevalent among the general population. Objective: This study aimed at surveying self-medication behavior among medical sciences students of Shiraz, Iran. Methods: A sample of 396 students from medical, paramedical, and health sciences disciplines were included in this cross-sectional study. They were asked to fill a questionnaire about their demographics and socioeconomic status, medication usage and self-medication in the last six months, information about the correct use of medication, and information about negative results of selfmedication. Data were analyzed using chi-square, t-test and logistic regression model using R statistical software. Results: Almost 72% of participants reported self-medication in the past sixth months. The main reasons included trust in their own diagnosis (59.9%), mildness of the disease (56.6%), and having previous experience about the disease (56%). Cough or cold (84.5%), headache (66.3%), and body pain (60.2%) were the most frequent diseases that led to self-medication. The majority of the participants (77.7%) reported they select their medicine on their own decision. Furthermore, self-medication was highly related to having medicine stock at home (OR=2.692), having less information about negative results of self-medication (OR=0.835), and more non-syllabus study time (OR=1.041). Conclusions: Although, medical science students have information about the treatment of illnesses, they should be more informed about negative results and side-effects of self-medication. They should also share their knowledge with society to decrease self-medication.

DOAJ (DOAJ: Directory of Open Access Journals), Jun 1, 2018

Background: specifying the determinants of healthcare expenditure is one of the most important ch... more Background: specifying the determinants of healthcare expenditure is one of the most important challenges in the health sector. The current study was aimed to assess factors affecting government health care expenditure in Iran. Methods: to identify short-term and long-term determinants of healthcare expenditure in Iran during 1971-2007, Auto Regressive Distributive Lag (ARDL) bound testing approach to co integration was used. The explanatory variables were defined into economic, demographic and supply side categories. The data were collected from the official websites of the Iranian Statistics Centre, Central Bank of Iran, and the Ministry of Health. Results: we found health care expenditures as necessary goods in both short-term and long-term. In long-term, per capita income (β = 0.815, P-value = 0.033), elderly population (β =-1.790, P-value < 0.001), and physician density (β = 3.204, P-value = 0.004) had effect on health care expenditure. In short-term per capita income (β = 0.577, P-value = 0.026) was the only factor that significantly affected health care expenditure. Conclusion: Government health expenditure is necessary goods in both short and long run. Thus governmental health care expenditure does should grow proportional to increase in national income. This could result to decrease in out of pocket payment.

International Journal of Medical Education, Nov 4, 2019

Objectives: To assess the validity and reliability of the Persian version of the Readiness for In... more Objectives: To assess the validity and reliability of the Persian version of the Readiness for Inter-Professional Learning Scale (RIPLS). Methods: A cross-sectional study was performed among final-year medical students in Iran. A total of 200 students completed the Persian versions of the RIPLS questionnaire using convenience sampling. To evaluate the construct validity of the RIPLS questionnaire, data were subjected to confirmatory factor analysis (CFA). Some goodness-of-fit indicators were used to assess the hypothesized model. The hypothesised models were tested with LISREL 7.8. Results: Cronbach's alphas for 9 teamwork and collaboration (TAC), 3 negative professional identity (NPI), 4 positive professional identity (PPI) and 3 Roles and responsibilities (RAR) items were 0.89, 0.60, 0.86 and 0.28 respectively. The whole RIPLS was found to be highly reliable (19 items; α= 0.94). The set of fit statistics show that the hypothesised four-factor model fits the sample data. Conclusions: The results of the study show that the Persian version of the RIPLS may be a valid and reliable scale. In addition, the results of CFA show that the hypothesised four-factor model appears to be a good fit to the data. However, the Persian version of the subscales of NPI and RAR needs to be developed. The implications and limitations of the study are discussed.

Medical Journal of The Islamic Republic of Iran

Theory-based studies have shown to bring about fresh and insightful ideas for teaching clinical r... more Theory-based studies have shown to bring about fresh and insightful ideas for teaching clinical reasoning and may fill in the gap between theory and practice in medical education research.

Medical Journal of the Islamic Republic of Iran

Clinical decision-making is a critical skill for the safety of mothers and infants. The KFs is an... more Clinical decision-making is a critical skill for the safety of mothers and infants. The KFs is an approach used to assess the decisionmaking skill of undergraduate medical and paramedical students. the development and assessment of this cognitive skill are essential in midwifery education.

Diabetes & Metabolic Syndrome: Clinical Research & Reviews

British Journal of Sports Medicine

ObjectiveTo evaluate the effectiveness of motor control training (MCT) compared with other physic... more ObjectiveTo evaluate the effectiveness of motor control training (MCT) compared with other physical therapist-led interventions, minimal/no intervention or surgery in patients with symptomatic lumbar disc herniation (LDH).DesignSystematic review and meta-analysis.Data sourcesEight databases and the ClinicalTrials.gov were searched from inception to April 2021.Eligibility criteriaWe included clinical trial studies with concurrent comparison groups which examined the effectiveness of MCT in patients with symptomatic LDH. Primary outcomes were pain intensity and functional status which were expressed as mean difference (MD) and standardised mean difference (SMD), respectively.ResultsWe screened 6695 articles, of which 16 clinical trials (861 participants) were eligible. Fourteen studies were judged to have high risk of bias and two studies had some risk of bias. In patients who did not undergo surgery, MCT resulted in clinically meaningful pain reduction compared with other physical th...

Background and Objectives: Clinical reasoning is a cognitive process that includes data gathering... more Background and Objectives: Clinical reasoning is a cognitive process that includes data gathering, interpreting, synthesizing information, generating hypotheses and diagnoses, developing management plans, avoiding medical errors, and providing patient safety. However, there is no substantial evidence in the literature about which educational strategies are used to improve medical students' clinical reasoning ability. To identify the range (clinical setting and academic discipline, duration of intervention), extent (number of studies according to every category), and nature (kind of strategy, knowledge/process-oriented, and serial cues/whole case) of educational approaches for teaching clinical reasoning in undergraduate medical education. Methods: The steps of this scoping review will be based upon Arksey and O'Malley framework for scoping reviews that includes the following five steps: Identifying the search question, Identifying the relevant studies, Study selection, Chart...

Journal of Advances in Medical Education & Professionalism, 2021

Introduction: Bedside teaching plays a crucial role in acquiring essential clinical skills. There... more Introduction: Bedside teaching plays a crucial role in acquiring essential clinical skills. Therefore, the main aim of this study is assessing the validity and reliability of the Persian version of German bedside teaching (BST) instrument. This instrument was specially developed for evaluation of bedside teaching. Method: The present cross-sectional study was conducted on 150 last year medical students, using convenience sampling. The Persian version of the bedside teaching (BST) was used for data gathering. To calculate the reliability of the questions, Cronbach's alpha was used and to determine the construct validity of the questionnaire, confirmatory factor analysis was used. All analyses were performed in LISREL 10 and SPSS 21 software. Results: Cronbach's alpha indicated excellent reliability for each subscale (α =0.77-0.85). All of the value of the questions are more than a significant number of 1.96 and concluded to be significant. There was an acceptable fit between ...

Biomedical Research-tokyo, 2017

Introduction: Clinical reasoning skills play a major role in the ability of physicians to make di... more Introduction: Clinical reasoning skills play a major role in the ability of physicians to make diagnosis and take an appropriate intervention for treatment of patients. The aim of this research is the comparison between the key features examinations and common multiple choice examinations for assessing the individuals’ clinical decision makings ability in obstetrics and gynaecology department. Methods: In this study, 59 midwifery students were participated. After each multiple choice examination, the Key features examination was held. The correlation between these two examinations was analysed. The reliability of the Key features examination was measured by the Cronbach’s alpha values. By means of the Whitney and Sabers method, difficulty index of questions was determined; and correlation of every question with the total examination was investigated by using SPSS software. Satisfaction of clinical reasoning assessment in top students was compared with weak students by using LIKERT s...

Journal of Advances in Medical Education & Professionalism, 2019

Introduction: Clinical reasoning as a critical and high level of clinical competency should be ac... more Introduction: Clinical reasoning as a critical and high level of clinical competency should be acquired during medical education, and medical educators should attempt to assess this ability in medical students. Nowadays, there are several ways to evaluate medical students’ clinical reasoning ability in different countries worldwide. There are some well-known clinical reasoning tests such as Key Feature (KF), Clinical Reasoning Problem (CRP), Script Concordance Test (SCT), and Comprehensive Integrative Puzzle (CIP). Each of these tests has its advantages and disadvantages. In this study, we evaluated the reliability of combination of clinical reasoning tests SCT, KF, CIP, and CRP in one national exam and the correlation between the subtest scores of these tests together with the total score of the exam. Methods: In this cross sectional study, a total number of 339 high ranked medical students from 60 medical schools in Iran participated in a national exam named “Medical Olympiad”. Th...

Background: Rapid demographic change and aging population demand that health professional’s espec... more Background: Rapid demographic change and aging population demand that health professional’s especially general physicians need to be better competent around older adults' care and managing multiple conditions of them. Evidence shows that the current gap in health care professionals’ skills and the lack of medical school training for caring well the aging population. Therefore, health professions need to improve geriatric competencies in the curriculum to care for and met older adult’s preferences.Objective: The objective of this scoping review is to identify core competencies relevant to geriatric care in the undergraduate medical curriculum.Methods: This scoping review protocol is based on the Arksey and O’Malley framework and further developed by Levac et al. Four databases including PubMed, ERIC, Scopus, and Web of Science will be searched. Citation searching for identifying additional studies, through reference lists checking of studies and reviews will be applied. Studies i...

Caspian Journal of Health Research, 2018

Background: Organizational efficiency should be continuously measured to plan for improvement, in... more Background: Organizational efficiency should be continuously measured to plan for improvement, informing about organizational performance, and guiding the university toward its goals. In this study, the authors measured the efficiency of schools affiliated to Tehran University of Medical Sciences as one of the most important universities in Iran, in 2011 and 2012. Methods: In this research, the efficiency of schools was measured using data envelopment analysis (DEA) technique in three dimensions of education, research, and development. Several indices in each dimension were assumed as input. Data were collected from university documents and analyzed by output oriented approach using DEAP software version 2.1. Results: Findings revealed that the efficiency scores of four schools including public health, pharmacy, nursing and midwifery, and advanced technologies were 100 in both years. In 2011, the efficiency scores for other schools were as follows:

Background: specifying the determinants of healthcare expenditure is one of the most important ch... more Background: specifying the determinants of healthcare expenditure is one of the most important challenges in the health sector. The current study was aimed to assess factors affecting government health care expenditure in Iran. Methods: to identify short-term and long-term determinants of healthcare expenditure in Iran during 1971-2007, Auto Regressive Distributive Lag (ARDL) bound testing approach to co integration was used. The explanatory variables were defined into economic, demographic and supply side categories. The data were collected from the official websites of the Iranian Statistics Centre, Central Bank of Iran, and the Ministry of Health. Results: we found health care expenditures as necessary goods in both short-term and long-term. In long-term, per capita income (β = 0.815, P-value = 0.033), elderly population (β =-1.790, P-value < 0.001), and physician density (β = 3.204, P-value = 0.004) had effect on health care expenditure. In short-term per capita income (β = 0.577, P-value = 0.026) was the only factor that significantly affected health care expenditure. Conclusion: Government health expenditure is necessary goods in both short and long run. Thus governmental health care expenditure does should grow proportional to increase in national income. This could result to decrease in out of pocket payment.

Physical Therapy, 2021

Objective Dry needling is a treatment technique used by clinicians to relieve symptoms in patient... more Objective Dry needling is a treatment technique used by clinicians to relieve symptoms in patients with tension-type headache (TTH), cervicogenic headache (CGH), or migraine. This systematic review’s main objective was to assess the effectiveness of dry needling on headache pain intensity and related disability in patients with TTH, CGH, or migraine. Methods Medline/PubMed, Scopus, Embase, PEDro, Web of Science, Ovid, Allied and Complementary Medicine Database/EBSCO, Cochrane Central Register of Controlled Clinical Trials, Google Scholar, and trial registries were searched until April 1, 2020, along with reference lists of eligible studies and related reviews. Randomized clinical trials or observational studies that compared the effectiveness of dry needling with any other interventions were eligible for inclusion. Three reviewers independently selected studies, extracted data, and assessed risk of bias. Random-effects meta-analyses were performed to produce pooled-effect estimates ...

British Journal of Sports Medicine, 2021

Current Drug Safety, 2020

Background: Self-medication could be risky behavior and has negative effects. While Over the Coun... more Background: Self-medication could be risky behavior and has negative effects. While Over the Counter (OTC) drugs are available at drugstores, the behavior has become prevalent among the general population. Objective: This study aimed at surveying self-medication behavior among medical sciences students of Shiraz, Iran. Methods: A sample of 396 students from medical, paramedical, and health sciences disciplines were included in this cross-sectional study. They were asked to fill a questionnaire about their demographics and socioeconomic status, medication usage and self-medication in the last six months, information about the correct use of medication, and information about negative results of selfmedication. Data were analyzed using chi-square, t-test and logistic regression model using R statistical software. Results: Almost 72% of participants reported self-medication in the past sixth months. The main reasons included trust in their own diagnosis (59.9%), mildness of the disease ...

Sleep and Breathing, 2011

There is a high worldwide prevalence of sleep quality disturbances, and sleep disturbances have b... more There is a high worldwide prevalence of sleep quality disturbances, and sleep disturbances have been associated with numerous diseases. Thus, it is important to assess sleep quality. The Pittsburgh Sleep Quality Index (PSQI) is a self-rating questionnaire that can be completed within 5 min, but no Persian language version is available. We translated the PSQI into Persian and then back into English to ensure the accuracy of the translation. A total of 125 psychiatric patients (generalized anxiety disorder, n = 37; major depression, n = 35; schizophrenia, n = 28; primary insomnia, n = 25) and 133 controls completed our Persian version of this questionnaire. Internal consistency, construct validity, and sensitivity and specificity of the PSQI were assessed. The mean ages (±SD) of the patient and control groups were 36.8 years (±13.9) and 34.2 years (±9.8), respectively (p = 0.08). Cronbach&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s alpha coefficient for all subjects was 0.77 and was 0.52 for the patient group and 0.78 for the control group. The corrected item-total correlations ranged from 0.30 to 0.75 for the seven component scores of the PSQI. When the general health questionnaire-12 was used as a measure of psychiatric morbidity, it was well correlated with the PSQI scores (r = 0.54, p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.001). The sensitivity and specificity of discrimination of insomniac patients from control subjects were 94% and 72% for a PSQI cutoff value of 5 and 85% and 84% for a PSQI cutoff value of 6. The psychometric properties of the Persian version of the PSQI were acceptable.

Caspian journal of health research, Jun 1, 2018

Background: Organizational efficiency should be continuously measured to plan for improvement, in... more Background: Organizational efficiency should be continuously measured to plan for improvement, informing about organizational performance, and guiding the university toward its goals. In this study, the authors measured the efficiency of schools affiliated to Tehran University of Medical Sciences as one of the most important universities in Iran, in 2011 and 2012. Methods: In this research, the efficiency of schools was measured using data envelopment analysis (DEA) technique in three dimensions of education, research, and development. Several indices in each dimension were assumed as input. Data were collected from university documents and analyzed by output oriented approach using DEAP software version 2.1. Results: Findings revealed that the efficiency scores of four schools including public health, pharmacy, nursing and midwifery, and advanced technologies were 100 in both years. In 2011, the efficiency scores for other schools were as follows:

DOAJ (DOAJ: Directory of Open Access Journals), Nov 1, 2020

Letter to Editor Dear Editor Emerging infectious diseases have always been one of the most seriou... more Letter to Editor Dear Editor Emerging infectious diseases have always been one of the most serious global public health threats. They have the potential to cause human infections, high economic burden, increased morbidity, and undermine the existing public health infrastructure. The ongoing battle against the epidemic of emerging infectious diseases requires frontline health professionals to work harder and become more diligent. Confronted with these demanding working conditions, medical and paramedical learners in teaching hospitals face numerous challenges, as they are at the forefront of providing primary medical services to patients suffering from COVID-19. For instance, they have to deal not only with the prejudice and social stigma of working with COVID-19 patients but also with the subsequent potential risk of contamination. 1 The tremendous emotional stress and potential suffering from anxiety form another challenge as learners witness the death of both colleagues and patients due to COVID-19 infection. Exacerbating the situation are the long hospital shifts, which potentially undermine the health safety and quality of life of learners. 2 Equally challenging are the long working hours, beyond mere professional dedication, which can lead to fatigue and burnout and adversely affect various aspects of their quality of life (health, physical, psychological, environmental, and social). 3 In turn, these exhausting conditions can lead to the relaxation of many of the usual safety standards, reduced quality of care, unethical behavior, and a higher risk of medical errors. 2 Empathy is an important factor in overcoming these challenges. It is defined as "The ability to understand and share another person's perspective and feelings, and using this understanding to guide future action". 4 Larson and others suggested that empathy can reduce aggressive behavior and improve helping behavior. 5 Empathy plays a fundamental role in the relationship between physicians and patients with COVID-19, as it involves cognitive, affective, and behavioral aspects. A prerequisite for successful management of patients with COVID-19 is to demonstrate empathy by all parties involved, from medical staff to medical and paramedical learners, patients, and their family caregivers. This has an immediate and longitudinal impact on patient-physician outcomes. Evidently, empathy has resulted in increased voluntary engagement by medical and paramedical students, both at undergraduate and postgraduate levels in managing COVID-19 patients. For example, both specialist physiotherapists and PhD candidates in physiotherapy have volunteered at various teaching hospital wards (dedicated to COVID-19 patients) to perform standard chest physiotherapy to improve patients' pulmonary function and reduce respiratory insufficiency. Medical interns have also voluntarily attended teaching hospitals to provide medical service to patients with COVID-19. Close collaboration between medical/paramedical learners and staff and between different hospital wards is essential in the fight against pandemic diseases such as COVID-19. Empathy cannot be achieved through explicit teaching alone. 5 Its development is a long process of learning medical ethics, role modeling, long-term observation of empathetic behavior demonstrated by health care professionals, and training on physician-patient communication skills. While empathy contributes to job satisfaction, the process of mastering empathetic behavior itself may result in psychological distress, emotional exhaustion, and burnout. 5 Therefore, medical education policymakers and heads of educational hospitals and clinical departments must address the specific physical and psychological needs of medical and paramedical learners. It is therefore recommended that nations invest more in wellness and health promotion. We trust that the global full-scale battle against COVID-19 will ultimately contribute to the enhancement of peace, collaboration, and friendship among nations. Together we will be able to defeat the COVID-19 pandemic.

Current Drug Safety, Feb 3, 2020

Background: Self-medication could be risky behavior and has negative effects. While Over the Coun... more Background: Self-medication could be risky behavior and has negative effects. While Over the Counter (OTC) drugs are available at drugstores, the behavior has become prevalent among the general population. Objective: This study aimed at surveying self-medication behavior among medical sciences students of Shiraz, Iran. Methods: A sample of 396 students from medical, paramedical, and health sciences disciplines were included in this cross-sectional study. They were asked to fill a questionnaire about their demographics and socioeconomic status, medication usage and self-medication in the last six months, information about the correct use of medication, and information about negative results of selfmedication. Data were analyzed using chi-square, t-test and logistic regression model using R statistical software. Results: Almost 72% of participants reported self-medication in the past sixth months. The main reasons included trust in their own diagnosis (59.9%), mildness of the disease (56.6%), and having previous experience about the disease (56%). Cough or cold (84.5%), headache (66.3%), and body pain (60.2%) were the most frequent diseases that led to self-medication. The majority of the participants (77.7%) reported they select their medicine on their own decision. Furthermore, self-medication was highly related to having medicine stock at home (OR=2.692), having less information about negative results of self-medication (OR=0.835), and more non-syllabus study time (OR=1.041). Conclusions: Although, medical science students have information about the treatment of illnesses, they should be more informed about negative results and side-effects of self-medication. They should also share their knowledge with society to decrease self-medication.

DOAJ (DOAJ: Directory of Open Access Journals), Jun 1, 2018

Background: specifying the determinants of healthcare expenditure is one of the most important ch... more Background: specifying the determinants of healthcare expenditure is one of the most important challenges in the health sector. The current study was aimed to assess factors affecting government health care expenditure in Iran. Methods: to identify short-term and long-term determinants of healthcare expenditure in Iran during 1971-2007, Auto Regressive Distributive Lag (ARDL) bound testing approach to co integration was used. The explanatory variables were defined into economic, demographic and supply side categories. The data were collected from the official websites of the Iranian Statistics Centre, Central Bank of Iran, and the Ministry of Health. Results: we found health care expenditures as necessary goods in both short-term and long-term. In long-term, per capita income (β = 0.815, P-value = 0.033), elderly population (β =-1.790, P-value < 0.001), and physician density (β = 3.204, P-value = 0.004) had effect on health care expenditure. In short-term per capita income (β = 0.577, P-value = 0.026) was the only factor that significantly affected health care expenditure. Conclusion: Government health expenditure is necessary goods in both short and long run. Thus governmental health care expenditure does should grow proportional to increase in national income. This could result to decrease in out of pocket payment.

International Journal of Medical Education, Nov 4, 2019

Objectives: To assess the validity and reliability of the Persian version of the Readiness for In... more Objectives: To assess the validity and reliability of the Persian version of the Readiness for Inter-Professional Learning Scale (RIPLS). Methods: A cross-sectional study was performed among final-year medical students in Iran. A total of 200 students completed the Persian versions of the RIPLS questionnaire using convenience sampling. To evaluate the construct validity of the RIPLS questionnaire, data were subjected to confirmatory factor analysis (CFA). Some goodness-of-fit indicators were used to assess the hypothesized model. The hypothesised models were tested with LISREL 7.8. Results: Cronbach's alphas for 9 teamwork and collaboration (TAC), 3 negative professional identity (NPI), 4 positive professional identity (PPI) and 3 Roles and responsibilities (RAR) items were 0.89, 0.60, 0.86 and 0.28 respectively. The whole RIPLS was found to be highly reliable (19 items; α= 0.94). The set of fit statistics show that the hypothesised four-factor model fits the sample data. Conclusions: The results of the study show that the Persian version of the RIPLS may be a valid and reliable scale. In addition, the results of CFA show that the hypothesised four-factor model appears to be a good fit to the data. However, the Persian version of the subscales of NPI and RAR needs to be developed. The implications and limitations of the study are discussed.

Medical Journal of The Islamic Republic of Iran

Theory-based studies have shown to bring about fresh and insightful ideas for teaching clinical r... more Theory-based studies have shown to bring about fresh and insightful ideas for teaching clinical reasoning and may fill in the gap between theory and practice in medical education research.

Medical Journal of the Islamic Republic of Iran

Clinical decision-making is a critical skill for the safety of mothers and infants. The KFs is an... more Clinical decision-making is a critical skill for the safety of mothers and infants. The KFs is an approach used to assess the decisionmaking skill of undergraduate medical and paramedical students. the development and assessment of this cognitive skill are essential in midwifery education.

Diabetes & Metabolic Syndrome: Clinical Research & Reviews

British Journal of Sports Medicine

ObjectiveTo evaluate the effectiveness of motor control training (MCT) compared with other physic... more ObjectiveTo evaluate the effectiveness of motor control training (MCT) compared with other physical therapist-led interventions, minimal/no intervention or surgery in patients with symptomatic lumbar disc herniation (LDH).DesignSystematic review and meta-analysis.Data sourcesEight databases and the ClinicalTrials.gov were searched from inception to April 2021.Eligibility criteriaWe included clinical trial studies with concurrent comparison groups which examined the effectiveness of MCT in patients with symptomatic LDH. Primary outcomes were pain intensity and functional status which were expressed as mean difference (MD) and standardised mean difference (SMD), respectively.ResultsWe screened 6695 articles, of which 16 clinical trials (861 participants) were eligible. Fourteen studies were judged to have high risk of bias and two studies had some risk of bias. In patients who did not undergo surgery, MCT resulted in clinically meaningful pain reduction compared with other physical th...

Background and Objectives: Clinical reasoning is a cognitive process that includes data gathering... more Background and Objectives: Clinical reasoning is a cognitive process that includes data gathering, interpreting, synthesizing information, generating hypotheses and diagnoses, developing management plans, avoiding medical errors, and providing patient safety. However, there is no substantial evidence in the literature about which educational strategies are used to improve medical students' clinical reasoning ability. To identify the range (clinical setting and academic discipline, duration of intervention), extent (number of studies according to every category), and nature (kind of strategy, knowledge/process-oriented, and serial cues/whole case) of educational approaches for teaching clinical reasoning in undergraduate medical education. Methods: The steps of this scoping review will be based upon Arksey and O'Malley framework for scoping reviews that includes the following five steps: Identifying the search question, Identifying the relevant studies, Study selection, Chart...

Journal of Advances in Medical Education & Professionalism, 2021

Introduction: Bedside teaching plays a crucial role in acquiring essential clinical skills. There... more Introduction: Bedside teaching plays a crucial role in acquiring essential clinical skills. Therefore, the main aim of this study is assessing the validity and reliability of the Persian version of German bedside teaching (BST) instrument. This instrument was specially developed for evaluation of bedside teaching. Method: The present cross-sectional study was conducted on 150 last year medical students, using convenience sampling. The Persian version of the bedside teaching (BST) was used for data gathering. To calculate the reliability of the questions, Cronbach's alpha was used and to determine the construct validity of the questionnaire, confirmatory factor analysis was used. All analyses were performed in LISREL 10 and SPSS 21 software. Results: Cronbach's alpha indicated excellent reliability for each subscale (α =0.77-0.85). All of the value of the questions are more than a significant number of 1.96 and concluded to be significant. There was an acceptable fit between ...

Biomedical Research-tokyo, 2017

Introduction: Clinical reasoning skills play a major role in the ability of physicians to make di... more Introduction: Clinical reasoning skills play a major role in the ability of physicians to make diagnosis and take an appropriate intervention for treatment of patients. The aim of this research is the comparison between the key features examinations and common multiple choice examinations for assessing the individuals’ clinical decision makings ability in obstetrics and gynaecology department. Methods: In this study, 59 midwifery students were participated. After each multiple choice examination, the Key features examination was held. The correlation between these two examinations was analysed. The reliability of the Key features examination was measured by the Cronbach’s alpha values. By means of the Whitney and Sabers method, difficulty index of questions was determined; and correlation of every question with the total examination was investigated by using SPSS software. Satisfaction of clinical reasoning assessment in top students was compared with weak students by using LIKERT s...

Journal of Advances in Medical Education & Professionalism, 2019

Introduction: Clinical reasoning as a critical and high level of clinical competency should be ac... more Introduction: Clinical reasoning as a critical and high level of clinical competency should be acquired during medical education, and medical educators should attempt to assess this ability in medical students. Nowadays, there are several ways to evaluate medical students’ clinical reasoning ability in different countries worldwide. There are some well-known clinical reasoning tests such as Key Feature (KF), Clinical Reasoning Problem (CRP), Script Concordance Test (SCT), and Comprehensive Integrative Puzzle (CIP). Each of these tests has its advantages and disadvantages. In this study, we evaluated the reliability of combination of clinical reasoning tests SCT, KF, CIP, and CRP in one national exam and the correlation between the subtest scores of these tests together with the total score of the exam. Methods: In this cross sectional study, a total number of 339 high ranked medical students from 60 medical schools in Iran participated in a national exam named “Medical Olympiad”. Th...

Background: Rapid demographic change and aging population demand that health professional’s espec... more Background: Rapid demographic change and aging population demand that health professional’s especially general physicians need to be better competent around older adults' care and managing multiple conditions of them. Evidence shows that the current gap in health care professionals’ skills and the lack of medical school training for caring well the aging population. Therefore, health professions need to improve geriatric competencies in the curriculum to care for and met older adult’s preferences.Objective: The objective of this scoping review is to identify core competencies relevant to geriatric care in the undergraduate medical curriculum.Methods: This scoping review protocol is based on the Arksey and O’Malley framework and further developed by Levac et al. Four databases including PubMed, ERIC, Scopus, and Web of Science will be searched. Citation searching for identifying additional studies, through reference lists checking of studies and reviews will be applied. Studies i...

Caspian Journal of Health Research, 2018

Background: Organizational efficiency should be continuously measured to plan for improvement, in... more Background: Organizational efficiency should be continuously measured to plan for improvement, informing about organizational performance, and guiding the university toward its goals. In this study, the authors measured the efficiency of schools affiliated to Tehran University of Medical Sciences as one of the most important universities in Iran, in 2011 and 2012. Methods: In this research, the efficiency of schools was measured using data envelopment analysis (DEA) technique in three dimensions of education, research, and development. Several indices in each dimension were assumed as input. Data were collected from university documents and analyzed by output oriented approach using DEAP software version 2.1. Results: Findings revealed that the efficiency scores of four schools including public health, pharmacy, nursing and midwifery, and advanced technologies were 100 in both years. In 2011, the efficiency scores for other schools were as follows:

Background: specifying the determinants of healthcare expenditure is one of the most important ch... more Background: specifying the determinants of healthcare expenditure is one of the most important challenges in the health sector. The current study was aimed to assess factors affecting government health care expenditure in Iran. Methods: to identify short-term and long-term determinants of healthcare expenditure in Iran during 1971-2007, Auto Regressive Distributive Lag (ARDL) bound testing approach to co integration was used. The explanatory variables were defined into economic, demographic and supply side categories. The data were collected from the official websites of the Iranian Statistics Centre, Central Bank of Iran, and the Ministry of Health. Results: we found health care expenditures as necessary goods in both short-term and long-term. In long-term, per capita income (β = 0.815, P-value = 0.033), elderly population (β =-1.790, P-value < 0.001), and physician density (β = 3.204, P-value = 0.004) had effect on health care expenditure. In short-term per capita income (β = 0.577, P-value = 0.026) was the only factor that significantly affected health care expenditure. Conclusion: Government health expenditure is necessary goods in both short and long run. Thus governmental health care expenditure does should grow proportional to increase in national income. This could result to decrease in out of pocket payment.

Physical Therapy, 2021

Objective Dry needling is a treatment technique used by clinicians to relieve symptoms in patient... more Objective Dry needling is a treatment technique used by clinicians to relieve symptoms in patients with tension-type headache (TTH), cervicogenic headache (CGH), or migraine. This systematic review’s main objective was to assess the effectiveness of dry needling on headache pain intensity and related disability in patients with TTH, CGH, or migraine. Methods Medline/PubMed, Scopus, Embase, PEDro, Web of Science, Ovid, Allied and Complementary Medicine Database/EBSCO, Cochrane Central Register of Controlled Clinical Trials, Google Scholar, and trial registries were searched until April 1, 2020, along with reference lists of eligible studies and related reviews. Randomized clinical trials or observational studies that compared the effectiveness of dry needling with any other interventions were eligible for inclusion. Three reviewers independently selected studies, extracted data, and assessed risk of bias. Random-effects meta-analyses were performed to produce pooled-effect estimates ...

British Journal of Sports Medicine, 2021

Current Drug Safety, 2020

Background: Self-medication could be risky behavior and has negative effects. While Over the Coun... more Background: Self-medication could be risky behavior and has negative effects. While Over the Counter (OTC) drugs are available at drugstores, the behavior has become prevalent among the general population. Objective: This study aimed at surveying self-medication behavior among medical sciences students of Shiraz, Iran. Methods: A sample of 396 students from medical, paramedical, and health sciences disciplines were included in this cross-sectional study. They were asked to fill a questionnaire about their demographics and socioeconomic status, medication usage and self-medication in the last six months, information about the correct use of medication, and information about negative results of selfmedication. Data were analyzed using chi-square, t-test and logistic regression model using R statistical software. Results: Almost 72% of participants reported self-medication in the past sixth months. The main reasons included trust in their own diagnosis (59.9%), mildness of the disease ...